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General NPI Number Information
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NPI Number | 1174737647
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Entity Type | Organization
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Legal Business Name | CHRISTIAN FAMILY COUNSELING, INC
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Dates
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Enumeration Date | 05/10/2007
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Last Update Date | 01/12/2015
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Provider Practice Location Address
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Address Line | 305 HANSON AVE SUITE 170
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City | FREDERICKSBURG
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State | VA
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Zip | 22401-3126
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Country | US
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Telephone | 540-361-4330
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Fax | 540-361-4331
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Provider Business Mailing Address
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Address Line | 305 HANSON AVE SUTIE 170
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City | FREDERICKSBURG
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State | VA
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Zip | 22401-3126
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Country | US
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Telephone | 540-361-4330
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Fax | 540-361-4331
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. WILLIS H. GAY
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Credential | LPC, LMFT
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Telephone | 54033614330
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 0707001766
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License Number State | VA
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